Treatment/procedure for nasal flair when smiling - Can Botox be used for this?

Question

I’m a fifty year old woman linterested in Botox or a surgical procedure with quick recovery for nasal flair. It’s only an issue when smiling. I’ve read about the use of Botox for this issue but through the years of research, I’ve yet to find any before and after photos or doctors who utilize Botox for this purpose. Is Botox not really used for this? I live in Tampa, Florida.

Ella Fedonenko, MD · Answer

Botox is very effective for nasal flair. I recommend injecting 2 units of Botox into the dilator naris muscles and LLSAN muscles on each side of the nose.

Erik Peterson, MD · Answer

Hi! Dr. Peterson here &mdash;
Yes, Botox can be used to reduce nasal flare when smiling. Small amounts are injected into the nasalis muscle, which controls nostril movement. Relaxing this muscle can soften the flare and create a more balanced appearance.
That said, it’s not as commonly performed as other facial Botox treatments, so before-and-after photos are harder to find. The results are temporary, typically lasting 3–4 months, and repeat treatments are needed to maintain the effect.
For a more permanent or surgical solution, a rhinoplasty or minor alar base modification can address nasal flare, but recovery is longer than with Botox.
The best next step is a consultation with a board-certified dermatologist or dermatologic surgeon experienced in facial aesthetics, who can evaluate your anatomy and recommend whether Botox or a surgical approach makes the most sense.

Lexie Wang, MD · Answer

Yes, botox can be used for this purpose, although it's not a very common reason which is why you've probably had a hard time finding someone who does it. I'd call around to local plastic surgeons and/or medspas to see if they offer this. It can be a little uncomfortable and tends ot wear off fast.

Ran Y. Rubinstein, MD · Answer

Hello and thank you for your question. At our practice we routinely utilize neuromodulators such as Botox to help diminish nasal flaring for the appropriate candidate. When injected into specific muscles around the nose, this treatment can reduce nostril flaring, especially during facial expressions. Hope this helps! Esther Litenatsky AGACNP-BC on behalf of Dr. Ran Y. Rubinstein, facial plastic surgeon in Newburgh, NY and Montvale, NJ.

Falguni Patel, MD, FACOG · Answer

Botox can be used to reduce nostril flare or prevent the tip of the nose from drooping when smiling, by relaxing muscles like the dilator naris and depressor septi nasi but results are subtle, temporary (about 3–6 months), and won’t reshape your nose structurally

Anil R. Shah, MD · Answer

Hello! My name is Jessica, I am a physician assistant, and one of the providers at Aesthetic Skin - Winnetka & Chicago. This is a great question. You're right to notice that Botox for nasal flare—particularly dynamic nostril widening when smiling—is not commonly showcased or widely advertised, and there’s a good reason for that. While Botox can be used to reduce nasal flare, it’s an off-label, highly specialized application that few injectors perform regularly. The technique involves injecting very small amounts of botulinum toxin into the nasalis muscle or levator labii alaeque nasi, which are responsible for nostril dilation and upper lip elevation during expressive movement. The reason you haven’t seen many before-and-after photos is because results are typically subtle, the treatment is not commonly requested, and most patients seek more noticeable rejuvenation procedures rather than this very targeted correction. If nasal flare is your only concern and you’re looking for a quick recovery option, Botox could be a viable, low-risk trial, especially since it wears off within 3–4 months. I hope this helps and best of luck!

Nelson Lee Novick, MD · Answer

The short answer is that a microdroplet or two of Botox into the "wings" at the base of the wings of the nose has been used for many years to treat smile-related nasal flaring. The reason that you likely have not seen much about this is because the problem is not that common and so the  demand for this particular treatment  approach is very uncommon and overshadowed by the more common treatment sites like the glabellar frown lines, crow's feet lines around the eyes, and the forehead worry lines. You would be wise to seek treatment by experienced, board certified cosmetic dermatologist injection expert.

Anna Chacon, MD, FAAD · Answer

Thank you for your thoughtful question. Nasal flaring that occurs when smiling is often due to overactivity of the dilator naris muscles, which can pull the nostrils outward or upward. While this can be a normal part of facial animation, it can become a cosmetic concern for some individuals.

Can Botox Be Used for Nasal Flaring?
Yes — Botox can be used to address nasal flaring in some cases, though it's a less common application and should be performed by someone experienced in advanced facial anatomy.

A very small dose (1–2 units per side) can be injected into the dilator naris muscle.

This weakens the muscle's contraction and reduces nostril flaring, especially when smiling or expressing.

The result is subtle but effective in properly selected candidates.

Why Is It Not Widely Seen or Documented?
It's a specialized injection technique, not routinely offered by all injectors.

Results are typically subtle and not as dramatic as other Botox applications, which is why before-and-after photos are rare.

Variability in anatomy and expression patterns also means that patient selection is key.

Alternative Options
If Botox is not sufficient or appropriate, other interventions include:

Surgical alar base modification (alar reduction):
A minor surgical procedure to permanently reduce nostril width or flare. This does involve downtime and may leave small scars.

Thread lifting (for dynamic nostril movement):
In select cases, lifting threads can help stabilize nostril movement but are less common and not always reliable for this issue.

Summary
Botox can be a valid option for treating nasal flaring when smiling, particularly if the cause is muscle overactivity. Though not widely publicized, it is used in advanced aesthetic practices and can offer a minimally invasive, low-downtime solution.

Camille Cash, MD · Answer

Botox can be used to soften the muscle reaction that causes nasal flaring.  The treatment is done in the office with final results seen after two weeks.  The treatment effects gradually fade over three to four months.